Conference Reviews

Creating the Big Picture of Sedation Services: Mission, vision, values and politics 

Reviewed by Élise W. van der Jagt, MD, MPH     

Critical to developing a highly successful pediatric procedural sedation service is to have not only a clear mission, vision and values for the service but also a missionary zeal to accomplish this in spite of the complexities of politics and often difficult circumstances. Dr. Connors started his presentation with a quote from the Harvard Business Review, “The best entrepreneurs are missionaries not mercenaries”, and proceeded to show the differences between them such as – mercenaries grasp opportunities, missionaries follow strategies; mercenaries lust for money, missionaries lust for meaning; mercenaries obsess over finances, missionaries obsess over value; mercenaries feel entitled as founders, missionaries welcome and credit the contributions of all;  mercenaries want success, missionaries want success plus significance.

With this as an opening statement and relating his personal experience of losing a brother to Wilm’s tumor (i.e. he has been on the patient/family side of medical care), he started with some “big ideas” that are essential for developing a successful sedation service. Start by identifying what patients need for successful diagnostic and therapeutic procedures to take place.  Optimal comfort, pain relief, and the ability to do a procedure well and efficiently are all essential parts of such high quality care and must be the goals.  This translates into a mission to provide access to the highest quality of care for tests and procedures outside of the operating theater by utilizing principles and operational tools (such as clinical algorithms, and clear roles, responsibilities, and qualifications for sedation providers, nurses and child life specialists) that are essential to being a Center of Excellence in Procedural Sedation. 

He especially emphasized the importance of working together as a team of disciplines including anesthesiology, child life, nursing, sedation providers and others, of aligning the resources so that the vision of a specialty service able to provide a full spectrum of expertise in providing optimal procedural comfort is accomplished, and of having shared values that are clearly articulated and agreed on.

At closing, he again emphasized the importance of “sticking to the concepts of basic entrepreneurship” in developing a successful procedural sedation service.  To help remember this, he showed the video “Leadership Lessons from the Dancing Guy”, a video often used for developing leadership skills.

In summary, an organized approach to developing a pediatric procedural service is essential, paying attention to all the aspects needed for optimal and efficient patient/family care; even more fundamental is a missionary-like approach to the process where strategic planning and implementation is done in partnerships that last, individual contributions are valued, success and significance is measured in the satisfaction of everyone involved,  and the highest value is given when the patient’s best possible outcome is attained.

This talk was helpful, inspirational and sure to catalyze both new and experienced sedation providers into renewed efforts in the care of children who need procedural comfort.

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